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Topic Review
Photon-Counting Computed Tomography
Photon-counting computed tomography (PCCT) is a new advanced imaging technique that is going to transform the standard clinical use of computed tomography (CT) imaging. Photon-counting detectors resolve the number of photons and the incident X-ray energy spectrum into multiple energy bins. Compared with conventional CT technology, PCCT offers the advantages of improved spatial and contrast resolution, reduction of image noise and artifacts, reduced radiation exposure, and multi-energy/multi-parametric imaging based on the atomic properties of tissues, with the consequent possibility to use different contrast agents and improve quantitative imaging.
  • 785
  • 22 Feb 2023
Topic Review
Renin–Angiotensin-System-Induced Cardiac Remodelling
The renin–angiotensin system (RAS) indicates its central role in the pathogenesis of cardiovascular remodelling via both hemodynamic alterations and direct growth and the proliferation effects of angiotensin II or aldosterone resulting in the hypertrophy of cardiomyocytes, the proliferation of fibroblasts, and inflammatory immune cell activation. 
  • 783
  • 18 May 2021
Topic Review
Phosphate in Vascular Calcification
Inorganic phosphate is essential for a variety of cellular processes, such as energy metabolism, bone formation, and synthesis of biomolecules, including phospholipids and nucleic acids. However, elevated serum phosphorus has emerged as a key risk factor for vascular calcification.
  • 780
  • 21 Dec 2021
Topic Review
EndMT
Endothelial mesenchymal transition (EndMT) is a complex biological process in which endothelial cells lose their specific markers, such as vascular endothelial cadherin (VE-cadherin), and acquire a mesenchymal or myofibroblastic phenotype, expressing specific products, such as α-smooth muscle actin (α-SMA) and type I collagen.
  • 779
  • 02 Jul 2021
Topic Review
Thrombosis
Thrombosis (from Ancient Greek θρόμβωσις thrómbōsis "clotting") is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel (a vein or an artery) is injured, the body uses platelets (thrombocytes) and fibrin to form a blood clot to prevent blood loss. Even when a blood vessel is not injured, blood clots may form in the body under certain conditions. A clot, or a piece of the clot, that breaks free and begins to travel around the body is known as an embolus. Thrombosis may occur in veins (venous thrombosis) or in arteries (arterial thrombosis). Venous thrombosis (sometimes called DVT) leads to a blood clot in the affected part of the body, while arterial thrombosis (and, rarely, severe venous thrombosis) affects the blood supply and leads to damage of the tissue supplied by that artery (ischemia and necrosis). A piece of either an arterial or a venous thrombus can break off as an embolus, which could then travel through the circulation and lodge somewhere else as an embolism. This type of embolism is known as a thromboembolism. Complications can arise when a venous thromboembolism (commonly called a VTE) lodges in the lung as a pulmonary embolism. An arterial embolus may travel further down the affected blood vessel, where it can lodge as an embolism.
  • 778
  • 27 Oct 2022
Topic Review
Mitral Paravalvular Leak
Paravalvular leak incidence after mitral surgical replacement ranges from 7% to 17%. Between 1% and 5% of these are clinically significant. Large PVLs can cause important clinical manifestations such as heart failure or haemolysis. Current guidelines consider that surgical reparation is the gold-standard therapy in symptomatic patients with paravalvular leak. However, these recommendations are based in non-randomized observational registries. On the other hand, transcatheter paravalvular leak closure has shown excellent results with a low rate of complications, and nowadays it is considered the first option in selected patients in some experienced centres.
  • 773
  • 11 Apr 2022
Topic Review
Osteopontin in Heart Failure
The matricellular protein osteopontin modulates cell–matrix interactions during tissue injury and healing. A complex multidomain structure of osteopontin enables it not only to bind diverse cell receptors but also to interact with various partners, including other extracellular matrix proteins, cytokines, and growth factors. Numerous studies have implicated osteopontin in the development and progression of myocardial remodeling in diverse cardiac diseases. Osteopontin influences myocardial remodeling by regulating extracellular matrix production, the activity of matrix metalloproteinases and various growth factors, inflammatory cell recruitment, myofibroblast differentiation, cardiomyocyte apoptosis, and myocardial vascularization. The exploitation of osteopontin loss- and gain-of-function approaches in rodent models provided an opportunity for assessment of the cell- and disease-specific contribution of osteopontin to myocardial remodeling.
  • 771
  • 26 Aug 2022
Topic Review
Primary Cilia in Acquired Heart Disease
Primary cilia are non-motile plasma membrane extrusions that display a variety of receptors and mechanosensors. Loss of function results in ciliopathies, which have been strongly linked with congenital heart disease, as well as abnormal development and function of most organ systems. 
  • 769
  • 24 Mar 2022
Topic Review
Effects of Finerenone’s Mechanism of Action
Finerenone is a novel, selective, nonsteroidal MRA that is efficacious in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). Steroidal MR antagonists (MRAs) are included in treatment paradigms for resistant hypertension and heart failure with reduced ejection fraction, while the nonsteroidal MRA finerenone was shown to reduce renal and cardiovascular outcomes in two large phase III trials (FIDELIO-DKD and FIGARO-DKD) in patients with chronic kidney disease and type 2 diabetes, respectively.
  • 769
  • 02 Sep 2022
Topic Review
Antioxidants supplementation in cardiovascular diseases
Oxidative stress may be defined as an imbalance between reactive oxygen species (ROS) and the antioxidant system to counteract or detoxify these potentially damaging molecules. This phenomenon is a common feature of many human disorders such as cardiovascular disease. Many of the risk factors, including smoking, hypertension, hypercholesterolemia, diabetes, and obesity are associated with an increased risk of developing cardiovascular disease involving an elevated oxidative stress burden, either due to enhanced ROS production or decreased antioxidant protection. There is a number of therapeutic options to treat oxidative stress-associated cardiovascular diseases. Numerous studies have focused on the utility of antioxidant supplementation. However, whether antioxidant supplementation has any preventive and/or therapeutic value in cardiovascular pathology is still a matter of debate. 
  • 766
  • 08 Mar 2021
Topic Review
Epicardial Adipose Tissue
The epicardial adipose tissue (EAT) is a metabolically active organ recently associated with heart failure and atrial fibrillation and classified as an independent risk factor for subclinical coronary artery disease. Some evidence suggests as the assessment of EAT using coronary artery calcium (CAC) might represent an additional tool to quantify patients’ cardiovascular risk.
  • 765
  • 28 Dec 2022
Topic Review
MRI for Evaluating DKD Noninvasively
Renal magnetic resonance techniques provide noninvasive information on renal volume, function, metabolism, perfusion, oxygenation, and microstructural alterations, without the need for exogenous contrast media.
  • 764
  • 10 Jun 2021
Topic Review
Coronary Microvascular Dysfunction
Coronary microvascular dysfunction (CMD) is defined as the clinical syndrome of angina, electrocardiographic ischemic changes in the absence of obstructive CAD. The pathophysiological basis is impaired microvascular vasodilatation, leading to inadequate increase in blood flow to match myocardial oxygen needs (previously referred to in the literature as “cardiac syndrome X”).
  • 762
  • 10 Sep 2020
Topic Review
Cardiac Arrest
Cardiac arrest (CA) is a frequent cause of death and a major public health issue. To date, conventional cardiopulmonary resuscitation (CPR) is the only efficient method of resuscitation available that positively impacts prognosis. Extracorporeal membrane oxygenation (ECMO) is a complex and costly technique that requires technical expertise. It is not considered standard of care in all hospitals and should be applied only in high-volume facilities. ECMO combined with CPR is known as ECPR (extracorporeal cardiopulmonary resuscitation) and permits hemodynamic and respiratory stabilization of patients with CA refractory to conventional CPR. This technique allows the parallel treatment of the underlying etiology of CA while maintaining organ perfusion. However, current evidence does not support the routine use of ECPR in all patients with refractory CA. Therefore, an appropriate selection of patients who may benefit from this procedure is key. Reducing the duration of low blood flow by means of performing high-quality CPR and promoting access to ECPR, may improve the survival rate of the patients presenting with refractory CA. Indeed, patients who benefit from ECPR seem to carry better neurological outcomes.
  • 759
  • 25 Feb 2021
Topic Review
Zinc Homeostasis
Research has indicated that zinc plays a consequential mechanistic role in the protection against oxidative stress as zinc is required for the proper functioning of the antioxidant system, the suppression of inflammatory mediators, and the modulation of zinc transporters. Recently, the mechanisms surrounding ZnT8, ZIP7, and metallothionein have shown to be of particular pathogenic importance and are considered as potential therapeutic targets in disease management. The literature has shown that zinc dysregulation is associated with diabetes and may be considered as a leading contributor to the deleterious vascular alterations exhibited by the disease. Although further investigation is required, studies have indicated the favorable use of zinc supplementation in the protection against and prevention of oxidative stress and its consequences over the course of the condition.
  • 758
  • 29 Mar 2022
Topic Review
ECG Signs in Cardiac Resynchronization Therapy Response Prediction
Cardiac resynchronization therapy (CRT) is a cornerstone therapeutic opportunity for selected patients with heart failure. For optimal patient selection, no other method has been proven to be more effective than the 12-lead ECG, and hence ECG characteristics are extensively researched. The evaluation of particular ECG signs before the implantation may improve selection and, consequently, clinical outcomes. The definition of a true left bundle branch block (LBBB) seems to be the best starting point with which to select patients for CRT. Although there are no universally accepted definitions of LBBB, using the classical LBBB criteria, some ECG parameters are associated with CRT response. In patients with non-true LBBB or non-LBBB, further ECG predictors of response and non-response could be analyzed, such as QRS fractionation, signs of residual left bundle branch conduction, S-waves in V6, intrinsicoid deflection, or non-invasive estimates of Q-LV which are described in newer publications. 
  • 758
  • 20 Nov 2023
Topic Review
Monocytes in Chronic Heart Failure
A long-term condition known as chronic heart failure (CHF) is an ongoing difficulty of the heart in pumping blood enriched in oxygen and required nutrients around the body’s tissues. CHF pathogenesis is associated with various causes, and inflammation is one of the most important factors promoting the condition. In addition, monocytes, a group of cells present in the blood and infiltrating tissues, are known to participate in both pro- and anti-inflammatory processes and thus affect myocardial remodeling over time.
  • 749
  • 14 Feb 2022
Topic Review
Capillary Leak Syndrome in COVID-19 and Cardiometabolic Disease
COVID-19 is a disease with multi-faceted clinical features, which vary from mild disease to fatal outcomes. The severity of the disease is associated with chronic low-grade inflammation and endothelial dysfunction underlying cardiometabolic diseases. Capillary leak, through endothelial hyperpermeability to proteins and the induction of pro-inflammatory, pro-coagulant pathways, has emerged as a pivotal pathogenetic factor of SARS-CoV-2 infection in cardiometabolic patients and as major etiology of hypoalbuminemia in severe COVID-19 cases. A great body of evidence supports the association of this condition with underlying metabolic derangement, and few remarkable indications regarding the role of metabolic disease in the incidence of systemic capillary leak syndrome flares have been noted. Further studies are needed to consolidate these findings and enlighten the pathophysiology behind them.
  • 747
  • 17 Oct 2022
Topic Review
Unmet Needs in Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) swiftly evolved from a disrupting technology towards mainstream therapy in the field of severe symptomatic aortic stenosis. A series of randomized evaluations established its role in treating severe aortic stenosis patients across all surgical risk categories, paving the way for an extension of its indications to younger low-risk patients with a longer life expectancy.
  • 744
  • 21 Nov 2022
Topic Review
Anticoagulation in Atrial Fibrillation Cardioversion
Atrial fibrillation (AF) patient care encompasses different possible management strategies which are classified as rhythm-control therapies, aimed at restoring and maintaining the sinus rhythm, and rate-control therapies, aimed at ensuring an appropriate control of heart rate during AF.
  • 743
  • 12 Aug 2021
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